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DR. WILLIS TILMON BEENE DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1922116292

Individual Registrant:
DR. WILLIS TILMON BEENE DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
615 N. JACKSON ST.  MAGNOLIA, AR 71754 US
Tel: 870-234-1110  Fax: 870-234-1112

Contact information for business:
P.O. BOX 1133 615 N. JACKSON ST. MAGNOLIA, AR 71754 US
Tel: 870-234-1110  Fax: 870-234-1112

Registration Information:
NPI: 1922116292
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AR2106

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
101570608AR05




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